title: [Enhanced prenatal HIV couple oriented counselling session and couple communication about HIV (ANRS 12127 Prenahtest Trial)].
abstract: BACKGROUND
  The Prenahtest study investigated the efficacy of a couple-oriented HIV counselling session (COC) in encouraging couple HIV counselling and testing, and improving intra-couple communication about sexual and reproductive health. We report here on the effect of COC on intra-couple communication about HIV.
  
  
  METHODS
  Within this 4-country trial (India, Georgia, Dominican Republic and Cameroon), 484 to 491 pregnant women per site were recruited and individually randomized to receive either the COC intervention, enhanced counselling with role playing, or standard post-test HIV counselling. Women were interviewed at recruitment, before HIV testing (T0), and 2 to 8 weeks after post-test HIV counselling (T1). Four dichotomous variables documented intra-couple communication about HIV at T1: 1) discussion about HIV, 2) discussion about condom use, 3) suggesting HIV testing and 4) suggesting couple HIV counselling to the partner. An intra-couple HIV communication index was created: low degree of communication ("yes" response to zero or one of the four variables), intermediate degree of communication ("yes" to two or three variables) or high degree of communication ("yes" to the four variables). To estimate the impact of COC on the intra-couple HIV communication index, multivariable logistic regressions were conducted.
  
  
  RESULTS
  One thousand six hundred and seven women were included in the analysis of whom 54 (3.4%) were HIV-infected (49 in Cameroon). In the four countries, the counselling group was associated with intra-couple HIV communication (P≤0.03): women allocated to the COC group were significantly more likely to report high or intermediate degrees of intra-couple communication about HIV (versus low degree of communication) than women allocated to standard counselling.
  
  
  CONCLUSIONS
  COC improved short-term communication about HIV within couples in different sociocultural contexts, a positive finding for a couple approach to HIV prevention.
authors.affiliation: Centre Inserm U897 « Épidémiologie et Biostatistique », Inserm, 146, rue Léo-Saignat, 33000 Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Plazy
authors.forename: J
authors.initials: J
authors.lastname: Orne-Gliemann
authors.forename: E
authors.initials: E
authors.lastname: Balestre
authors.forename: M
authors.initials: M
authors.lastname: Miric
authors.forename: S
authors.initials: S
authors.lastname: Darak
authors.forename: M
authors.initials: M
authors.lastname: Butsashvili
authors.forename: P
authors.initials: P
authors.lastname: Tchendjou
authors.forename: F
authors.initials: F
authors.lastname: Dabis
authors.forename: A
authors.initials: A
authors.lastname: Desgrées du Loû
mesh_terms: D000293:Adolescent; D000328:Adult; D003376:Counseling / Q000379:methods; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D055815:Young Adult
keywords: Communication; Couple; Dépistage et conseil prénatal; HIV; Prenatal testing and counselling; Prevention; Prévention; VIH